Heroin and nicotine dependence are two addictions for which new combined pharmacotherapy/behavioral therapy interventions are possible. The goal of this mentored clinical scientist award is to promote the developing research skills of Maria A. Sullivan, M.D., Ph.D., by providing two areas of clinical research for testing novel combined medication/therapy strategies for opiate and nicotine dependence. Dr. Sullivan, a Board-Certified Psychiatrist, has completed a successful research fellowship in the Division on Substance Use at Columbia University/New York State Psychiatric Institute (NYSPI). As a fellow, Dr. Sullivan has begun studying patterns of smoking among schizophrenic patients and carried out a pilot intervention using bupropion/behavioral therapy to treat nicotine dependence among patients with chronic psychosis. This year Dr. Sullivan has joined the staff in the Division as an Assistant Professor of Clinical Psychiatry. She is currently serving as the Co-Director for the NIDA funded grant, "Opiate Dependence: Combined Naltrexone/Behavior Therapy." In the next several years, Dr. Sullivan plans to carry out clinical treatment trials to explore novel combined pharmacotherapy/psychotherapy approaches to opiate and nicotine dependence. Her proposed research plan will enable her to develop skills in two specific areas of addiction psychiatry: (1)conducting double-blind pharmacotherapeutic trials of agents which target specific mood symptoms in opiate or nicotine dependence or withdrawal; and (2)developing manualized psychotherapies tailored to promote abstinence and relapse prevention for individuals abusing certain classes of drugs. In this way, Dr. Sullivan will be well prepared to achieve her long-term research career goal of developing treatment approaches for comorbid substance use/psychiatric disorders. Under the sponsorship and guidance of Dr. Herbert Kleber, together with the faculty and resources available at Columbia University, Dr. Sullivan's training plan combines formal course work with clinical research experience at several sites of the New York State Psychiatric Institute. She will be working closely with several preceptors to receive training in the following areas: design and methods of clinical treatment studies; controlled medication trials; developing and implementing manual-guided relapse prevention therapies for opiate and nicotine dependence in selected populations; and biostatistics and epidemiology. Her specific research plan includes double-blind placebo-controlled trials of bupropion for nicotine dependence and nefazodone with open-label naltrexone for opiate dependence. For both treatment studies, manual-guided relapse prevention therapies will be developed and implemented. Dr. Sullivan's planned research will provide her with unique training and will afford her the opportunity to develop a clinical research career focused on developing new combined medication/therapy approaches to the treatment of substance abuse disorders.